Dearbhail McDonald on freezing her eggs: 'My only regret is not doing it sooner'
Dearbhail McDonald spoke at the Institute of Directors' 'Lunch Bites' event yesterday, at the National Concert Hall. Bringing the issues of fertility, and the relevance between what goes on in the bedroom and the boardroom to the fore, read her address, in its entirety below, including how Brexit night in 2016 took on a far more personal meaning for the Group Business Editor at Independent News & Media
IN 'The Handmaid’s Tale', Margaret Atwood’s dystopian novel, human fertility rates collapse, resulting in the few remaining fertile women - the handmaids – being forced into ritualised rape by Gilead, the totalitarian government.
Sales of the book have skyrocketed since last year’s US Presidential election – make of that what you will.
I do not stand before you today in a red cloak, nor do I ply apocalyptic warnings during my lunch break.
But I want to talk about something we don’t talk about.
And that is childbirth, the decline in fertility rates and the acute pressures facing women of child-bearing age, beyond those seemingly intractable debates about gender pay, ticking clocks and work-life balance.
I want to talk to you about how a “perfect demographic storm” could imperil economic growth and political stability across Europe and other industrialised economies.
But mostly I want to engage your views on the kind of workforce and society we are creating for our young men and women, trying to achieve their full potential whilst protecting the bottom line of your business and bearing the burden of supporting a rapidly ageing population.
FERTILITY & FAMILY: THE BIG PICTURE
Global fertility rates are in decline, a trend most pronounced in industrialised countries in general and Western Europe in particular.
This is not an abstract issue.
Yesterday, in a keynote address on the Future of Europe, President Michael D Higgins addressed a wide range of issues including falling populations.
He said that we need to accept that in the Europe of the future, all EU states will be small states even if they don’t realise that yet.
“Look at the list of the top sixty cities in the world in terms of population,” said President Higgins. How many [of those] cities are in the European Union, he asked?
“The answer is one and don’t celebrate yet because it’s currently getting ready to leave,” was his reply.
Europe’s demographic challenge is now a major priority for the European Stability Mechanism.
Last Tuesday Klaus Regling, the Managing Director of the ESM, warned that Europe must boost productivity in the face of “poor demographics”, citing low fertility rates, the need to increase the participation of women in the workforce and the need to raise the retirement age.
It was also the week that the Polish Government launched a 30-second video encouraging its citizens to breed like rabbits to address that country’s decreasing fertility rate.
€3m was spent on the controversial campaign whose tagline is “If you ever want to be a parent, follow the example of rabbits”. Catchy.
Japan has long been the perilous pathfinder in the demographic time bomb debate.
It is on course to hold the title of the world’s highest dependency ratio, 96 dependents – children than 15 and adults over the age of 65 – for every 100 workers by 2050.
The Bank of International Settlements (BIS) has also rowed in on the impact of changing global demographics, predicting last month higher interest rates and slower growth rates for most developed countries.
It also comes weeks after BMI Research, a Fitch company, warned that Germany must make difficult political choices over the next 10 years.
As we know, Germany has a major demographic problem, with both a rapidly ageing and falling population that has given birth to a birth deficit of around 150,000 babies a year.
The overall dependency ratio in Germany could increase the burden on government social spending to “potentially unsupportable levels” by 2050, BMI notes.
If Germans don’t have more babies, they will have to come from immigration.
Tackling declining working-age populations with ever more open immigration policies appears, on the face of it, to be an open and shut case.
But the backlash against Angela Merkel’s Open Door policy in the wake of the migration crisis that erupted in Europe in 2015, which coincided with a rise in terrorist activity across the region, proves this to be anything but.
Brexit, dominated by vituperative if ill-informed debates about immigration and the election of Donald Trump as US President are – along with vital debates about the future of Europe itself - testament to the challenges to immigration simpliciter as a solution to low fertility rates and labour shortages.
They also augur the difficult geo-political tensions that may lie ahead.
So, where is Ireland in all of this?
Yes, we have the second highest fertility rate in Europe and a population set to grow, on an all-island basis, to pre-famine levels of 8m by 2040.
But not so fast.
Ireland was, for many years, a demographic exception within Europe.
But our fertility rate has fallen to 1.89, less than the 2.1 average needed to keep the population stable, absent immigration.
Yes, our population in the Republic will grow by up to 1m by 2030.
But the main driver of that 20pc increase will be inward migration, not babies.
We, too, are facing a demographic time bomb, with an anticipated 90pc increase in those aged over 80 by 2030 even though that valued cohort of citizens will constitute just 3pc of the population.
By 2030, life expectancy will rise from 78 to nearly 83 years for men and from almost 83 years to 87 for women.
That’s great news: prolonged human life is a sign of prosperity.
But that longevity, combined with a low fertility rate, will place huge demands on our public services.
I got a huge insight to this the 4th Global Forum on Human Resources for Health at the RDS where we heard that there a global shortage of up to 18 million health workers by 2030.
KPMG calculates that for the five people currently working for every one person over 65 in Ireland, there will only be three for every person over 66 in 2050.
By 2030, our pension costs will have doubled from current levels to €12bn – we’re going to need one hell of a fiscal space to manage that.
In line with many developed countries that have enjoyed economic growth and that have invested heavily in the education of its youth, the Irish are doing lots of the big stuff later in life.
We are marrying later, but we aren’t saving early enough.
We’re having fewer babies and we’re making them much later in life than previous generations.
The average age of a mother in 1985 was 29.2 years. It’s now 32.5.
Despite our baby making repute, Irish women are, in fact, leaving it later than any other country in Europe to have children, with all of the attendant challenges later births bring.
The majority of women in the EU give birth to their first child in their 20s: in Ireland more than 50 per cent of women give birth to their first child in their 30s.
In 1981, mothers under the age of 30 accounted for nearly six out of ten of births: they account for less than a third of all births now.
Ireland is also above the EU average for first-time mothers in their 40s, with the number of births to mothers aged 40 increasing.
In 2015 6.4pc (or 4,175) of births to mothers aged 40 and over.
Our households are getting smaller and our Total Period Fertility Rate (TPFR) is also going south.
This key rate has fallen by almost a third in the past 30 years: we’ve been below the replacement level since 1991.
At the same time, we are seeing exponential growth in the global IVF and assisted human reproduction market.
It is a growth that is propelled, amongst other things, by the growth in the average age of first-time mothers, declining fertility rates and a rapid decline in male infertility, which is often overlooked in the population debate but has now taken centre stage.
Earlier this year, a landmark study revealed that sperm counts across the developed world have halved over the last forty years.
Hagai Levine from the Hebrew University of Jerusalem, one of the authors of the first systematic review and meta-analysis of sperm count trends, gave a stark warning in relation to the fall-off in sperm counts which has implications beyond fertility, with correlations between lower sperm counts and an increased risk of diabetes, heart disease and premature death in men.
“Eventually we may have a problem, [and] with reproduction in general,” said Lavine.
“And it may be the extinction of the human species”.
This study should set alarm bells ringing: men, not just women, need to talk about fertility.
WHY IT MATTERS
We know why all of this matters.
You see it in your businesses and private lives every day.
The grotesque attrition of our brightest and best women from the talent pipeline and leadership roles, the underemployment of and often the collapse in confidence of women who return to work – often part time – after having children or caring for sick or elderly parents.
The young families who delay having children because of fears of how it will impact their careers.
Those who don’t have that second or third child because they can’t afford our high living and excoriating childcare costs.
Those who don’t even get started because they can’t afford to buy or rent a home or achieve the basic quality of life milestones needed to support a family.
Those who are caught in a parent trap of many dimensions, the sandwich generation, trying to raise their own families later in life whilst balancing the needs of elderly parents and dependents – the dependency ratio nightmare we spoke about earlier.
We made enormous strides in encouraging women to participate equally with men in the workforce, with 58pc of Irish women having completed third level education compared to 44pc of men.
That is an enormous achievement. But then we abandoned women at the equality and caregiving gate.
You know this.
The shame of the brain drain and the proliferation of so many still pitiful statistics.
The fact that more than 50pc of our surgical trainees are women, when just 7pc are consultants - ditto in many of our professional services.
70pc of our global healthcare workers are women, with few in key leadership positions.
We know of the World Economic Forum (WEF) data that indicates it will take 61 years for gender parity to be achieved in Europe, how our female representation in the Dail is lower than in many sub-Saharan democracies.
You know these hard facts – and their consequences.
You know it goes to the heart of how women are treated in society.
You know the dependency ration determines how we will tax and spend.
You know why businesses ultimately can’t afford to ignore this agenda – just ask Aileen O’Toole and her colleagues at WOW who this week launched the phenomenal #WomanUp initiative.
You know that investors will shun those who do not embrace diversity and, increasingly, demography.
Phrases like “social license” and “sustainability” are sometimes thrown around in the corporate world like snuff at a wake.
But we know that the societies and economies that perform best are those that are inclusive, diverse and support its workforce in their formative i.e. childbearing years.
And we have to ask: what kind of world are we creating for our young men and women?
What are the implications for the future of work in a country whose USP has been its young, educated workforce?
What happens when we add in rapid technological advances into the fertility and family mix?
Automation, AI and VR and those technologies we can’t even conceive yet will, I believe, have many transformative and positive effects.
But as Germany has learned with its open immigration policies, technology, on its own, won’t be a magical fix.
We shouldn’t underestimate the challenges of social and cultural cohesion posed by integration at a time when many people fear their jobs will not exist or will be displaced by technology in the coming years.
We must also be mindful of the geo political risks posed by income inequality where the richest 1pc in the world owns half of its wealth.
There are also other forces such as war, persecution, fertility booms on other parts of the world and climate change that has much of the planet on the move
We know that our responsibilities as leaders and influencers extend beyond quarterly targets and annual reports.
We know, deep down, that what happens in the privacy of our bedrooms should be a priority in our boardrooms and corridors of power: family is the highest expression of the public interest.
Critically, we have to ask are we creating a market or society - the two are not mutually exclusive – where family is ancillary instead of the bedrock that supports stable and thriving economies?
If I seem somewhat passionate about this topic, it’s because this issue is bigger than baseline stats in economic reports. It’s about achieving our full potential.
It is also because this is not just a public challenge, it’s deeply personal for so many of us.
And I am – in my own small way - the living embodiment of the choices that many of your daughters, co-workers and employees may face having myself taken out “eggsurance” – or having my eggs frozen.
I’ve hesitated as to whether I should share that information publicly as the reason for freezing your eggs is almost always a deeply personal one.
One that involves coming to terms with the grief for the children you may never have; one that involves reviewing every major decision you have made in respect of your personal relationships, wondering what advice would I give now to my 26-year-old self?
It is also that involves re-evaluating every single step of your vocation or career, no matter how successful it is to outsiders looking in.
I am beyond privileged to have achieved many milestones in my career and hope there are many more to come.
I have enjoyed untold rewards. But that hasn’t stopped from asking ‘Is this it’ at the end of a 12 or 14-hour shift, a 60 or 70-hour week or contemplating other uncomfortable questions about my own fertility journey.
And whether she has children or not, every woman has one.
I’ve asked: did I not yet have children because I committed to my career? Would I have got this far if I had children? Could I stay here if I did?
All of these questions and many more, rational and irrational, course through your mind.
And I am not alone in thinking them.
My own decision to freeze my eggs was initially painful, then pragmatic and, in the end, quite empowering.
My only regret is that I didn’t do it sooner.
Operation Frozen, as my friends dubbed it, also threw up some lighter moments too.
Working during the night with independent.ie’s digital and business teams on last year’s Brexit vote, we were stunned as sterling fell in global markets and the world woke up to the reality of that seismic shock.
All minds were focused in that newsroom on Brexit.
But all I could think of, in the wee small hours, was the fact that my frozen eggs had just crashed out of the European Union – for me it was all about EGGXIt, not Brexit!
That leads me to my last point and a much more serious one about the public dialogue around fertility and reproductive justice in Ireland.
I travelled to the UK to freeze my eggs in part for privacy reasons, but mostly because I live in a country where there are no laws on reproduction, no proper protection for my oocytes.
But I also travelled overseas because I live in a country where there is a deep and visceral shame about reproductive autonomy and women’s fertility journeys.
Leave aside, for one moment, your personal feelings about abortion and the perennially divisive 8th amendment and consider this: because we have failed to clarify the legal status of the unborn, we have no laws on IVF, surrogacy, embryo transfer – a deeply complex legal and ethical issue - and other reproductive practices that have flourished in a legal vacuum.
And we are utterly unprepared for the next wave of profound ethical, legal and medical challenges as it relates to fertility and childbirth.
This includes dead-but-alive women acting as cadaveric incubators as we had in the tragic Miss P case two years ago.
It also includes the fact that science now has the capacity now to alter or edit the human genome, a development that has radically altered human reproduction irrevocably.
The next frontier is pre-implantation genetic screening and diagnosis and the future prospect – successfully trialled in lambs – of ectogenisis, or growing and sustaining life in an artificial womb, matters that are beyond this paper.
I mention the 8th briefly not to dwell on the substantive debate about abortion, currently before the Oireachtas Committee, but to highlight the censorious, silencing effect it has had on much-needed conversations around fertility, family and, yes, the future of work.
We need to talk about pregnancy.
We need to talk about fertility and family.
We need to talk about the future.
This is such a vast and complex area, that I can do little today except pose questions.
Do we publicly fund IVF? I believe that we must.
But should the State offer fertility analysis and egg or sperm freezing to women and men in their 20s or early 30s to reduce costs associated with so-called geriatric pregnancies?
If the paternity leave carrot is not working, do we beat men with a mandatory to stick to offset the discriminatory effects on women’s careers because of childbirth?
How do we change our employment laws and, critically, how – in a Post Weinstein world that has highlighted the abuse of so many women in their workplaces and beyond, do we change our culture?
How can we support women in all the valid, rational and at times difficult choices that they make?
How do we educate and support men about the vital role they play and the risks to their own fertility?
At the individual level, fertility trends can be tragic.
And whilst the end of humanity is not approaching and I’m not donning my handmaid’s cloak just yet, the public case for an informed fertility debate is beyond dispute: what happens in the bedroom matters in your boardroom.